Background: PROMs occurs in 10% of all term pregnancies and
about 2- 4% of preterm pregnancies and is associated with
complications such as infection and preterm birth. Vaginal fluid
urea and creatinine levels may be helpful in the diagnosis of
PROM. Objectives: To evaluate the reliability of vaginal
washing fluid urea and creatinine as biomarkers for diagnosis of
preterm PROM. Subjects and Methods:A prospective case control study was conducted at the Obstetrics and Gynecology
Department; Benha University Hospital during the period from
September 2018 to September 2019. The study included 100
cases: 50 inpatient cases with preterm PROM and 50 cases from
those attending outpatient clinics for routine antenatal care. All
patients underwent speculum examination, nitrazine paper test,
and U/S. Results: The creatinine levels were 0.35 ±0.12 mg/dl
and 0.16± 0.08 mg/dl in confirmed cases and controls,
respectively. The urea levels were 6.5 ±2.48 mg/dl and 3.4 ±1.68
mg/dl in confirmed cases and controls, respectively. There was a
highly significant difference regarding creatinine level and urea level (P < 0.001). Sensitivity,
specificity, PPV and NPV for creatinine level were 100%, 84%, 86,2% and 100%, respectively.
Sensitivity, specificity, PPV and NPV, for urea level was 100%, 80%, 83.3% and 100%,
respectively, with a cut-off value of 0.2 mg/dl for creatinine level and 3 mg/dl for urea level.
Conclusions: Detection of vaginal fluid urea and creatinine to diagnose PROM is a simple,
reliable and rapid test with high sensitivity, specificity, PPV, NPV.
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